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General NPI Number Information
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NPI Number | 1154126498
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Entity Type | Individual
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Provider Name | MELISSA KRISTINE DEISTER APRN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2420 SW 17TH ST STE 150
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City | TOPEKA
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State | KS
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Zip | 66604-2627
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Country | US
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Telephone | 785-329-3499
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Fax |
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Provider Business Mailing Address
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Address Line | 7245 SW 53RD ST
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City | TOPEKA
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State | KS
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Zip | 66610-9115
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Country | US
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Telephone | 620-794-6958
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-84046-062
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License Number State | KS
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